September 25, 2018

The Honorable Mitch McConnell The Honorable Charles Schumer

Majority Leader Minority Leader
United States Senate United States Senate
Washington, DC 20510 Washington, DC 20510

The Honorable Paul Ryan The Honorable Nancy Pelosi

Speaker Minority Leader
United States House of Representatives United States House of Representatives
Washington, DC 20515 Washington, DC 20510

Dear Leader McConnell, Leader Schumer, Speaker Ryan and Leader Pelosi:

We are writing to urge you to preserve the actions Congress took in the Bipartisan Budget Act
(BBA) of 2018 to protect seniors and taxpayers from out-of-control drug prices. Over the past
five years, drug manufacturers have increased the prices of brand name drugs at 10 times the rate
of inflation – creating a health crisis that leaves one in four Americans unable to afford the
medications they need. Now, more than ever, it is critical that Congress keep in place the
important policies enacted in the BBA that help lower high out-of-pocket prescription drug costs,
particularly for those facing the highest cost burdens. As such, we urge you to stand with
Medicare beneficiaries and taxpayers to resist any attempts from the pharmaceutical industry to
undo these critical reforms.

The BBA included important provisions to improve the affordability of prescription drugs for
seniors by closing the Medicare Part D coverage gap or “doughnut hole” one year earlier and
requiring higher drug manufacturer discounts on brand name prescription drugs for enrollees
while they are in that coverage gap. The higher discount will help reduce out-of-pocket costs for
seniors and lowering their premiums.

Now, rather than build off the progress Congress has made to lower out-of-pocket costs brand-
name drug manufacturers are actively working to reverse this change at the expense of patients
and taxpayers by reducing the manufacturer discount from 70 to 63 percent. Moving forward
with such a proposal would dramatically increase costs for seniors and taxpayers, who will be
forced to subsidize what amounts to a multi-billion-dollar bailout for the price-gouging
pharmaceutical industry.

Patients enrolled in Medicare Part D – particularly those with limited incomes – should never
have to make the choice between buying groceries for their families and purchasing the
medications they need to get and stay well. Unfortunately, that’s a reality too many Americans
are facing due to continued efforts by drug manufacturers to increase profits, regardless of who is
harmed. That’s why we’re urging you to thwart any efforts by the pharmaceutical industry to
lower the drug manufacturer discount in the Part D program.
Prescription drug prices will continue to increase at unsustainable rates unless Congress
continues to hold the pharmaceutical industry to account for out-of-control drug prices.
Conversely, tying a bailout for the pharmaceutical industry to any legislative efforts will come at
the expense of patients and taxpayers and send the exact opposite message – especially if the
purpose of the vehicle is to help Americans fight opioid addiction, an epidemic that the drug
companies themselves helped create in the first place.
We look forward to our continued work with you to adopt and implement bipartisan, market-
based solutions that will slow the unsustainable growth in prescription drug prices for U.S.
consumers and their families without imperiling the discovery of innovative breakthrough
therapies that can improve the health and well-being of patients.

Sincerely,

AARP
AFSCME
American Academy of Family Physicians
American Gastroenterological Association
American Hospital Association
America’s Health Insurance Plans
Blue Cross Blue Shield Association
Blue Cross Blue Shield of Michigan
Blue Shield of California
Campaign for Sustainable Rx Pricing
Families USA
National Coalition on Health Care
Medicare Rights Center
Kaiser Permanente
Patients for Affordable Drugs
UAW Retiree Medical Benefits Trust